Recovery from post tib tendonitis

14 messages
14/06/2008 at 10:57
Has anyone had and recovered from post tib tendonitis? I've got flat feet but have used orthotics for the last decade and was recently diagnosed with posterior tibial tendonitis by my physio. Two weeks of following her recomendations and it's no better perhaps even worse. I've googled the condition (bad move) and I'm wondering if its game over. I could do with hearing from people who have recovered fully from it.
cheers......
14/06/2008 at 20:57

i have - but then i run a lot less than i used to due to 2yr old son.  if i went up to earlier mileage, i suspect it would be back.

lots of sports massages got me through running a marathon with no significant tib post problems - although did end up with dodgy achilles.  massage therapist used to get her thumbs in the tendon and pop out the knots.  you could hear them - it was gross.  brutal but effective.

no real suggestions, though for final cure.  i am supposed to do lots of ankle stability exercises because that's where my weakness is that causes the tib post probs. i've never really done them consistently enough to know if it helps.  perhaps worth thinking about.

14/06/2008 at 22:03

I got this at the end of last year combined with a tibial stress fracture. No running for 4 months seems to have cured things!

I am starting again and taking it really slowly hoping to avoid shin splints/tibial stress recurring or the post tib tendinitis. I too run with orthotics. Until  I'm able to run decent distances without them recurring I guess I'm not cured. My phys gave me exercises to strengthen the joint - basically standing on tiptoe on the stairs and then lowering slowly to stretch and strengthen.

I'm barely running again but have not experienced the problems I was having. Even aqua running was causing the post tib to flare so I'm glad I rested it. 

15/06/2008 at 21:59

I actually ruptured my L tib post and carried on using it for 3 months before seeing a doctor.  I put the pain down to old age!  I ended up having surgery and now wear custom-made orthotics permanently (ordinary shoes and running ones).  What helped me (post surgery) was physio/exercise, orthotics, motion-control shoes (originally Saucony, now Nike) fitted by specialist shop, arch support socks, stretching and patience (the latter being particularly difficult at times!).  I started running 2 years ago and the tib posts (both feet) were fine, but in doing too many miles too soon, caused severe plantar fascia damage (on the R foot ie the non-surgically enhanced foot) and ended up being unable to run for 18 months.  I've now just started back and am taking it extremely slowly, as above, but, all being well, consider myself living (?!) proof that it is possible to stage a comeback!!

Hope you get on OK, I had a great surgeon and team of phsyios - although progress was exceedingly slow, I did see a result each time I went.  If you aren't maybe you should consider another physio............? 

16/06/2008 at 12:48

Thans for the info guys..... i have to say  it doesn't sound like a particularly easy injury to handle. Time to become much more involved in foot and ankle exercises whilst i take a month or so out of running. I was up to 6 miles every other day aswell which was making me feel quite chirpy. I'll post again if i have any progress either way.

 Cheers...

16/06/2008 at 15:10

Just a quick work "Your Lordship" - would be careful about the mileage that you are doing, I think that you are possibly doing too much.  When I started running 2 yrs ago, I was doing the same mileage as you, and in the same way.  My plantar fascia injury was caused by my increasing my weekly mileage too quickly and I think that  you may need to allow more time for recovery between each run.  I'm now following a training plan, run, cross train, rest, run, cross train, run,rest. (I per day of the week).  The runs are 1)gentle run 2)form run (ie mix of techniques to build speed) and 3) long run (endurance and stamina).  It has helped me and it is intended for those returning to running post injury, so perhaps once you're back and running it might be worth consideration.  I;ve also just started Pilates to strenghen core muscle groups and funnily enough, my class is full of runners.

Hope you do recover and if you want any more info, post a thread and I'll reply.  BTW book is by John Bingham, "Marathon running for mortals" ( from memory).

Good luck 

Nam
16/06/2008 at 15:24

I too had tibialis posterior tendonitis.  Worse in my right than left.  My right is my mechanically worse foot.  A good 12 weeks rest eventually did it, whilst maintaining other cross training (cycling was fine).

Orthotics helped, but I also feel they make my tib posts even lazier... so decided to do some POSE execises and see if I can (witch much patience and essentially starting from scratch in terms of distance) learn not to heel strike and to run on my forefoot.  Worked my way up to 2 miles... so far so good... 

16/06/2008 at 17:49

I have had this too.  Didn't run at all last Nov or Dec (though was able to cross train, mainly stepper) and was getting pretty despondent - like you I did a lot of symptom surfing and scared myself silly thinking I would never run again! 

But I went to see an excellent podiatrist at the end of Dec who said that the problem had been caused by a new pair of shoes that were not supportive enough.  As I don't overpronate I keep getting sold neutral shoes but the podiatrist said I really need something more supportive as I have hypermobile feet.  By luck the shoes I had previously been wearing were actually more like a support shoe although sold as neutral, which is why the problem hadn't occurred before.

Although the injury still hurt a bit at this stage, the podiatrist said it was fine to start running again, providing I wore the right shoes.  She didn't recommend orthotics or give me any exercises to do.  So back in the old model of shoes I started run-walking at the beginning of Jan.  It gradually hurt less and less and I was able to run continously for 35 mins by the beginning of Feb.  From then on things improved rapidly - I had hardly lost any fitness with the cross training and was able to run a half marathon in the middle of March with no pain.  And it's absolutely fine now.

My main worry now is that the shoes that suit me have been discontinued and I need to find a replacement - and soon!

17/06/2008 at 09:22

 CJBA, Nam and Lilf thanks for the replies, it's relieving to hear that people can get past it.

CBJA, thanks for the book recomendation. 

Nam, what exactly are POSE exercises?

 Lilf, the pain for me came after 4 runs (5 milers) on new moderate pronation control shoes (sauc progrid omni6) having used neutral ones for years. My physio advised i tried them (even though i use custom orthotics) and i'm wondering if i should have treated them like breaking in orthotics rather than jumping straight in. I do notice a massive difference to my old neutral brooks.

 Thanks again guys....

Edited: 17/06/2008 at 09:22
17/06/2008 at 14:08
Lord L - that's interesting.  Mine came on in exactly the same way, after about 4 runs of 4-5 miles, although it was Brooks that did the damage with me.  I would go back to your old shoes if I was you, esp if you had no problems before.  Anyway, good luck with it, I'm sure you'll be back running soon.
17/06/2008 at 15:05

lord hackney - be careful running with orthotics in supportive shoes.  i've always been told by physios etc that i should run in neutrals with orthotics, but i do need supportive shoes otherwise my flippety floppety ankles go a bit mad. but certainly can't run in anything too structured.  did you get your new shoes fitted by a running shop while you were wearing your orthotics?   i actually got my podiatrist to check me afterwards, even though the running shop said they were fine. (they were actually - i was just being paranoid!)

my injury started when i switched from tri to running only (due to time pressures).  so i think overuse and overenthusiasm with building up mileage (had bags of fitness but obviously not developed the muscular control for just running).  i have weak glutes also apparently (although i have a huge arse - how does that work?!) and am told that combined with the wobbly ankles is bad news for tib post.

odd that there are so many sufferers.  when i posted about it a couple of years ago, only 1 person seemed to have got it and he got it from football.  i'm glad there are a few more of us!

Nam
17/06/2008 at 15:11
lord hackney wrote (see)

Nam, what exactly are POSE exercises?


http://www.posetech.com/ 
09/10/2012 at 21:44
I've just completed an ultra a few weeks ago (60 miles) and can't shift the left forefoot pain and I think I've probably got t p tendinitis. I'm seeing my physio later this week to confirm.. I have no other injuries at all and can't quite believe this.. I was hoping to start running gently on Monday, but now unsure. I'm so fit and can't stand the thought of losing it
10/10/2012 at 21:56
Hi Ruth. I've been suffering with this since February and am just getting back to running now. Im sure you will be back quicker than me though. I had watched my husband run an ultra a couple of weeks - I was very envious. Which one did you do? He did the hardmoors 60. Beth

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